In plastic surgery, reduction mammaplasty is a common operation. The incidence of occult breast cancer detection is low but if diagnosed, consequences for the patient and the attending physician have a great impact. In this case, a 55-year-old woman complained of physical discomfort because of macromastia. Reduction mammaplasty was performed. Histopathological analysis revealed breast cancer of the breast reduction specimen. Once this diagnosis was made, the physicians looked more thoroughly into the patient's history, and a risk analysis focused on breast cancer. On a multidisciplinary level it was decided that ablation of the left breast with limited axillary lymph node dissection was the most feasible treatment. It may be evident that surgical outcomes and treatment options were complicated and limited because of the recently performed operation. This illustrates the value of adequate history taking, supply of information as well as consideration of certain pre- and postoperative screening methods.